Patient Educationand Counseling

Prepared by : Dr.Hemat Afifi Sherif

Introduction

Lack of sufficient knowledge about their health

problems and medications

one cause of patients’ non-adherence to their

pharmaco-therapeutic regimens and monitoring

plans

Improve patient adherence Reduce medication-related problems.

knowledge skills

Educating Counseling

CaregiversIndividual

Patients

Patient

Groups

Families

Educating Counseling

preventative in nature.

It foresees the potential

problems

prepares the learner ahead

of time with possible

scenarios and solutions to

those problems.

It has more to do with

the now, why, and how of

things.

It can be given in a formal

setting among a group or

individually as the need

requires.

After the fact.

It is the reaction to

occurrences and

negative situations that

need to be corrected,

altered, or changed.

It is given more on an

individual basis and in a private setting

knowledge

patients’ cultures

Health and illness

beliefs

Attitudes Practices.

patients’ feelings

Toward the health

system

Views of their own roles

and responsibilities for

decision-making and for

managing their care

Assessing a patient’s

Cognitive abilities

Learning style

Sensory and physical status

Whether patients know how to use their

medications

whether a patient is willing to use a medication

A patient may be unable

to hear oral instructions

may lack sufficient motor

skills to open a child-

resistant container.

A patient may lack the

visual acuity to read labels

on prescription containers,

markings on syringes, or

written handout material.

skills

1. Effective, open-ended questioning

2. Active listening

3. Adapt messages to fit patients’ language skills

4. Observe and interpret the nonverbal messages e.g.

Eye contact

Facial expressions

Body movements

Vocal characteristics

1. Comfortable

2. Confidential3. Safe

In a room or space that ensures privacy and

opportunity to engage in confidential

communication.

Environment

common area can be restructured to maximize

visual and auditory privacy from other patients

or staff.

Patients, including those who are disabled, should

have easy access and seating.

Space and seating should be adequate for family

members or caregivers

The design and placement of desks and counters

should minimize barriers to communication.

Distractions and

interruptions should

be few, so that

patients and

pharmacists can

have each other’s

undivided attention.

The environment should be equipped with

appropriate learning aids e.G.

Graphics

Anatomical models

Medication administration devices

Memory aids

Written material

Audiovisual resources.

To determine what specific information and

counseling are required in each patient care

situation.

Collaboration With Other Health Care

Team

Home care

Patient Education And Counseling

Guidelines Are Applicable In All Practice

Settings—including

Acute inpatient care

Long-term care

Ambulatory care

Patient education and counseling usually occur:

at the time prescriptions are dispensed

but may also be provided as a separate service.

Education Time

Pharmacist and

Patient Roles

assess that The patients have

sufficient:

understanding

Knowledge

skill

to follow their pharmaco-

therapeutic regimens and

monitoring plans.

seek ways to motivate

patients to:

learn about their

treatment

be active partners in

their care.

Pharmacist Roles

pharmacists may also have disease management roles

and responsibilities for specified categories of patients

Depending on:

The health system’s policies and procedures

Its use of protocols or clinical care plans

Patient Roles

Adhere to their pharmaco-therapeutic regimens

Monitor for drug effects

Report their experiences to pharmacists or other

members of their health care teams.

seeking information

and presenting

concerns that may

make adherence

difficult.

Process

Steps

Introduce yourself as a pharmacist

Explain the purpose and expected length of

the sessions

Obtain the patient’s agreement to

participate

1

Assess the patient’s:

Knowledge about his or her health

problems and medications

Physical and mental capability to use the

medications appropriately

Attitude toward the health problems and

medications

2

Ask open-ended questions about each

medication’s purpose and what the

patient expects

Ask the patient to describe or show how

he or she will use the medication

They should also be asked to describe

any problems, concerns, or

uncertainties they are experiencing with

their medications

3

Provide information orally and use visual aids

or demonstrations to fill patients’ gaps in

knowledge and understanding

4

Open the medication containers to show

patients the colors, sizes, shapes, and

markings on oral solids.

Demonstrate the assembly and use of

administration devices such as nasal and oral

inhalers.

For oral liquids and

injectable, show patients the

dosage marks on measuring

devices.

As a supplement

to face-to-face oral

communication,

provide written

handouts to help

the patient recall

the information.

Then adjust the pharmacotherapeutic regimens

according to protocols or notify the

prescribers.

If a patient is experiencing problems with his or

her medications, gather appropriate data and

assess the problems.

Verify patients’ knowledge and understanding of

medication use

5

Ask patients to describe or show how they will

use their medications and identify their effects

Observe patients’ medication-use capability and

accuracy and attitudes toward following their

pharmaco-therapeutic regimens and monitoring

plans.

Content

1

The medication’s trade name

generic name

common or other descriptive name(s)

when appropriate

its therapeutic class and efficacy.

The medication’s use and expected benefits and

action.

whether the medication is intended to :

cure a disease, eliminate or reduce symptoms

arrest or slow the disease process, or prevent

the disease or a symptom.

2

The medication’s route

dosage form

Dosage

administration schedule (including duration of

therapy).

3

4

The medication’s expected onset of action and

what to do if the action does not occur.

Directions for preparing and using or

administering the medication.

This may include adaptation to fit patients’

lifestyles or work environments

Action to be taken in case of a missed dose.

6

5

Precautions to be observed during the

medication’s use or administration

The medication’s potential risks in relation to

benefits.

For injectable medications and administration

devices, concern about allergy may be discussed.

7

Techniques for self-monitoring of the

pharmacotherapy.

Potential common and severe adverse effects

that may occur

actions to prevent or minimize their

occurrence

actions to take if they occur

including notifying the prescriber, pharmacist,

or other health care provider.

8

9

Potential drug–drug (including nonprescription)

Drug–food

Drug–disease interactions

Contraindications.

10

The medication’s relationships to radiologic

and laboratory procedures

(e.g., timing of doses and potential interferences

with interpretation of results).

11

Proper storage of the medication.

12

Proper disposal of contaminated or discontinued

medications and used administration devices

13

14

Any other information unique to an individual

patient or medication

Additional content may be appropriate when

pharmacists have authorized responsibilities in

collaborative disease management for

specified categories of patients.

These points are applicable to both

prescription and nonprescription medications.

Pharmacists should counsel patients in the

proper selection of nonprescription

medications.

3. Recognition and monitoring of disease

complications.

Depending on the patient’s disease management

or clinical care plan, the following may be

covered:

1. The disease state:

whether it is acute or chronic

its prevention, transmission, progression, and

recurrence.

2. Expected effects of the disease on the patient’s

normal daily living.

Documentation

Pharmacists should document education and

counseling in patients’ permanent medical

records as consistent with:

the patients’ care plans

the health system’s policies and procedures

Education and counseling may be

documented

When pharmacists do not have access to

patients’ medical records

1. In the pharmacy’s patient profiles

2. On the medication order or prescription

form

3. On a specially designed counseling

record.

All documentation should be safeguarded to respect patient confidentiality and privacy

The Pharmacist Should Record

That counseling was

offered and was

accepted and provided or refused

The pharmacist’s

perceived level of the

patient’s

understanding

As appropriate, the content should be

documented (for example, counseling about

food–drug interactions).

Thank you

ASHP Guidelines

on Pharmacist-Conducted

Patient Education and Counseling

Reference